- SGI Global, LLC (Raleigh, NC)
- SGI Global is seeking a Civil Investigator ( Healthcare Fraud and Opioid Matters) to support Affirmative Civil Enforcement ("ACE") Program for the ... position is contingent upon contract award** Responsibilities + The Civil Investigator will assist in conducting thorough...extensive research and analysis of data relating to suspected civil violations, such as healthcare fraud… more
- Gilead Sciences, Inc. (Foster City, CA)
- …live or their economic status. **About the Role** The global pharmaceutical crime and healthcare fraud market is currently estimated at $400 billion annually. It ... and will lead and accelerate the development of the group's pharmaceutical crime and healthcare fraud program. The role will include both people leadership and… more
- Humana (Oklahoma City, OK)
- …on business needs. **Required Qualifications** + **Must reside in Oklahoma** + Healthcare fraud , waste, and abuse investigations experience + Knowledge of ... first** Humana Healthy Horizons in Oklahoma is seeking a Fraud and Waste Professional 2 who conducts investigations of... healthcare payment methodologies + Strong organizational, interpersonal, and communication… more
- MyFlorida (Tallahassee, FL)
- …or education requirements of s. 943.135. Preference will be given to candidates with healthcare fraud investigative experience working in a Medicaid Fraud ... LAW ENFORCEMENT INVESTIGATOR II - 41000785 Date: Apr 23, 2024...experience, or five (5) years of work experience conducting healthcare fraud investigations. Note: All newly hired… more
- Louisiana Department of State Civil Service (Baton Rouge, LA)
- …approach to uncover abuse and neglect of residents and complex financial fraud committed by healthcare providers, including hospitals, nursing homes, pharmacies, ... INVESTIGATOR /SPECIAL AGENT (1-3) Print (https://www.governmentjobs.com/careers/louisiana/jobs/newprint/4372786) Apply ...cyber crimes, white collar crimes, and public corruption. Medicaid Fraud Control Unit: The Louisiana Medicaid Fraud … more
- CVS Health (Springfield, IL)
- … you will conduct high level, complex investigations of known or suspected acts of healthcare fraud and abuse. Routinely handles cases that are sensitive or high ... cases involving multi-lines of business, or cases involving multipleperpetrators or intricate healthcare fraud schemes * Investigates to prevent payment of… more
- CVS Health (Tallahassee, FL)
- …Components: - Conducts high level, complex investigations of known or suspected acts of healthcare fraud and abuse. - Routinely handles cases that are sensitive ... multi-disciplinary provider groups, or cases involving multiple perpetrators or intricate healthcare fraud schemes. - Investigates to prevent payment of… more
- Veterans Affairs, Veterans Health Administration (St. Cloud, MN)
- …par with crimes such as homicide, involve an extensive supply chain fraud network, large scale drug diversion, prostitution rings requiring surveillance, and/or ... personnel visiting or working at a VA property. Responsibilities The Criminal Investigator reports to the Chief of Police. Major duties and responsibilities include:… more
- MyFlorida (Tallahassee, FL)
- …Preferred Qualifications: Industry certifications, eg, Certified Fraud Examiner; Accredited Healthcare Fraud Investigator ; Certified Financial Crimes ... working with law enforcement personnel to prepare cases for civil or criminal actions. Knowledge, Skills, and Abilities: +...Investigator ; Certified Insurance Fraud Investigator , Certified Compliance and Ethics Professional.… more
- CDPHP (Albany, NY)
- …Analyst will be responsible for researching, investigating, and resolving instances of healthcare fraud and/or abusive conduct by internal employees, the medical ... agencies to support a management decision to pursue criminal, civil or other recovery action on the basis of...Coder (COC) Certification is preferred. + Accredited Health Care Fraud Investigator (AHFI(R)) accreditation to be obtained… more